Season 5 Case 31

Season 5 Case 31

Case 31

History: abdominal pain unspecified (of course)


Answer:

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Case 31 Answer

Findings: Picture 1

Enhancing mass in the central mesentery with spoke-like projections (not too much tethering)

Picture 2 - enhancing intraluminal mass in the distal ileum

Answer: Carcinoid tumor with mesenteric metastasis

Remember that the mesenteric mass, usually enhancing and often with spicules and surround retraction/tethering is actually a mesenteric metastasis from a smaller primary. Since the small bowel is the most common primary location these days, look closely for the primary.

Good reference on all things carcinoid: http://www.ajronline.org/doi/pdf/10.2214/AJR.12.9758